Monday, January 4, 2016

Study Finds Rehospitalization May Be Associated With Increased Vulnerability to Suicide

Inpatient hospitalization is considered essential for treating adolescents who report severe suicidal thoughts or actions. However, a significant number of adolescents continue to experience suicide-related outcomes after discharge, including rehospitalizations, emergency department visits, persistent suicidal ideation, and repeated suicidal behavior.

A study published today in Psychiatric Services in Advance has found that rehospitalization shortly after a psychiatric hospitalization is a strong indicator of the future risk of suicide attempt, which has important implications for the clinical management of readmitted adolescents.

This study involved 373 adolescents (aged 13 to 17), who were hospitalized because of acute suicidal ideation or a recent suicide attempt. Researchers measured suicidal ideation and attempts, psychiatric rehospitalization, and more within one week of hospitalization, and follow-up data were collected three, six, and 12 months later. Participants were grouped into one of three categories based on their suicidal ideation levels during the course of the year: chronically elevated, initially elevated but declining, and subclinical (low ideation).

The researchers found that being rehospitalized within three months after the index hospitalization was associated with greater risk of suicide attempts.

Among adolescents with chronically elevated or initially elevated but fast declining ideation, rehospitalization was also associated with higher average levels of ideation compared with teens who were not rehospitalized; however, in subclinical teens, rehospitalization had a protective effect and reduced average ideation scores.

“Our findings have implications for intervening with readmitted adolescents, including the need for posthospitalization services, addressing potentially self-defeating cognitions about hospitalization, and addressing realistic expectations with adolescents and families,” the study authors wrote.

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